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Montana rates for HCPCS 64400

Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)

Facilitymedian $191 · 10th–90th $87$4270%10%20%10th90th$191Professionalmedian $115 · 10th–90th $56$2690%10%20%10th90th$115$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $426.58 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $112.20 / $251.19
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$162.18 / $407.38 / $831.76
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $81.28 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $117.49 / $177.83
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $194.98 / $218.78
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $194.98 / $218.78
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $125.89 / $218.78
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $102.33 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $117.49 / $208.93